Feb. 3, 2010 -- Inner-city asthma sufferers who take herbal remedies tend to
have worse symptoms and to use their inhalers less, researchers find.

Do these patients rely too much on unproven herbal remedies? Or are they
turning to alternative treatments because they aren't getting enough relief from
their medications?

That's not yet clear. What is clear is that doctors treating asthma patients
should ask about their use of herbal remedies -- particularly if their asthma
isn't under control.

"Although complementary/alternative medicine may be acceptable for some
patients with preferences for using these products, it needs to be used in
conjunction with prescribed [inhalers]," note researchers Angkana Roy, MD, of
New York's Mount Sinai School of Medicine, and colleagues.

A recent study found that as many as four in five adults with asthma report
having used complementary or alternative medicines. Roy and colleagues wondered
whether patients were using these products in place of inhalers, which are
considered essential to asthma control.

To explore the issue, the researchers surveyed patients with persistent
asthma being treated at outpatient clinics in East Harlem, New York City; and in
New Brunswick, N.J.

They asked 326 adult patients, "Sometimes people use home remedies, such as
teas, rubs, and herbs for asthma. In the past six months, have you used any of
these remedies?"

They also rated how well patients had their asthma under control and gave
them questionnaires on their knowledge and beliefs about asthma.

They found that the 25% of patients who used herbal remedies were actually
better informed about the lung inflammation at the heart of asthma than those
who did not use the remedies. Herb users were more likely to be worried about
the side effects of their inhalers, and had more trouble following their
medication schedule.

That last finding, Roy and colleagues say, may suggest a reason why herbal
remedy users used their inhalers less than they were supposed to. It could
explain why they had worse disease than those who did not use the remedies.

On the other hand, they note, "Increased severity of illness may lead
patients to use herbal remedies as a last resort when conventional therapy is
not working."

Whether or not either of these explanations is true, the researchers advise
health care workers to have a non-judgmental conversation about strategies to
improve patients' asthma control.

The Roy study appears in the February issue of Annals of Allergy, Asthma &
Immunology.